Permit (77) CITY OF TIGARDi 4-2.7/ PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018 00326
13125 SW Hall Blvd.,Ti Date Issued: 08/08/2018
TIt_r,1R and OR 97223 503.718.2439 9
Parcel: 2S 111 ACO2700
Jurisdiction: Tigard
Site address: 14650 SW 97TH AVE
Project: Twality Middle School Subdivision: None Lot: None
Project Description: Connecting(5)new modular restroom buildings to water service.
Contractor: CALIBER PLUMBING&MECHANICAL INC Owner: UNION HIGH SCHOOL DISTRICT
6036 N CUTTER CIRCLE, SUITE 360 NO. 3 JT
PORTLAND, OR 97217 00000
PHONE: 971-563-1672 PHONE:
FAX:
FEES
Quantity Description Date Amount
25 If Water Service 07/05/2018 $62.54
Specifics: 1 12%State Surcharge- 07/05/2018 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 07/05/2018 $9.96
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r i
Issued By: ,,CV y
idx/ r� Permittee Signature: ® ,f,,.._J /
•
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Site Utilities ,,,,,,,,,,„__IVL FOR OFFICE USE ONE)
.., City Tigard Tl and Received
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Z01� Date/By: 7 V/ j- �0i� a ' i
I Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: {j7-
_ Date/By: cJ!�p�id'/fllJ3
T I G A R D Inspection Line: 503.639.4175 CITY OF 'ROAR .Pate Ready/By: Juris I2/ See Page 2 for v
Internet www.tigard-or.gov ! �� t I 1 Tied/Method: IFS- Supplemental Information
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®New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. 1 Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
� fi'' 4 , ' 's. is Iz le,(>4`. 6 SFR(1)bath 312.70
0 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler
sq.ft.) Page
2
'4w!''''''''''.°;111;4 '.-
4 i `jig 7 d r Site utilities:
, av1 y r
Job site address:14650 SW 97th Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:Twality Middle School Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:25) 1 Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
,�y ��° , y, ,,, , Backwater valve 12.51
Clothes washer 25.02
Connnecting 5 portlables to water service,
Dishwasher 25.02
5'per portable water service connection Drinking fountain 25.02
Ejectors/sump 25.02
Expansion tank 12.51! i@ 1 r
25.02
Name: Fixture/sewer cap
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
'.A.-0,,,,z- r /ms
Inrceptor/grease rap// U �;i ie ;;i 0Ht vv4. , g 25.02
Business name:Caliber Plumbing&Mechanical Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Matt Dorn
Roof drain(commercial) 12.51
Address:6036 N Cutter Circle,Ste 360 Sink/basin/lavatory 25.02
City/State/ZIP:Portland,OR 97217 Solar units(potable water) 62.54
Phone:(503)206-7591 Fax::(503)285-5769 Tub/shower/shower pan 12.51
Urinal 25.02 accounts*calibermechanical.com c ��x�rr Water closet 25.02 rr . 4)fia �` ; ',k,4,;''';1: w14eff` i d z ce,,. ,. , ✓ , ,.
Water heater 37.52
Business name:Caliber Plumbing&Mechanical Water piping/DWV 56.29
Address:6036 N Cuter Circle,Ste.360 Other: 25.02
City/State/ZIP:Portland,OR 97217 Subtotal 62.54
Phone:(503)206-7591 Fax:(503)285-5769 Minimum permit fee: $72.50
Plan review (25%of permit fee) ""
CCB Lic.:208245 Plumbing Lic.no.:PB 1658
State surcharge(12%of permit fee) ' 70
Authorized signature: get/( TOTAL PERMIT FEE X',
Print name:Dan Hannah Date:7/3/18 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(I0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
• Fee Schedule: Residential Fire S i ression Systems:
ent>< >< up essi
Footing drain-151 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 $233.20
greater- I st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 1 62.54 62.54 Medical Gas S stems:
Water Service-each additional 100' 37.52 _
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
e`F g, each additional$100.00 or fraction thereof,to
# € ¢ g I rf /:° and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
minimum char:e-1/2 hour and including$25,000.00.
Inspections outside of normal business 90.00/hr - $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours minimum char_e-2 hours each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr - $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
minimum char:s 1/2 hour each additional$100.00 or fraction thereof.
Subtotal: _
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
f. Ye - goy s. 6 s
Y1for 1ta Plan review is required for any of the following.
?. erfortut•< Capped Added
Please check all thatapply.
Baptistry/Font
CIBath Tub/Shower Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain ts.
Garbage Domestic-non-food CI Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
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